The COVID vaccines are so new that there is no direct scientific data to guide a clear direction on the timing of getting steroid injections relative to getting the vaccines currently. The concern is not that there would be a direct interaction between the two drugs. The concern is that theoretically the steroid might diminish the strength of the body’s immune response to the vaccine. The effect of both the Pfizer-BioNTech and Moderna vaccines depend on a robust immune response after receiving both doses of the vaccine. Potentially the timing of a steroid injection could help reduce the risk of decreased immunogenicity of these vaccines.
Many patients have been asking about the timing of getting the COVID vaccines relative to their upcoming steroid injections. Since there is no definite science to inform our recommendations, we have reviewed the available information and have come up with the following guidance. Remember this information is general and each person’s health history is unique so, each decision should be considered case by case.
It may be wise based on an abundance of caution without any real proof to schedule an elective injection no more than two weeks but at least one week before receiving a vaccine dose. After receiving each dose there is likely no diminished effect of the immune response after two weeks so, it should be safe to have a steroid injection any time after seven days. These guidelines are a work in progress and are based on the assumptions of what we know about how these vaccines work. As more data becomes available it may be necessary to update or change these recommendations.
There is no direct evidence that steroid injections make either of the vaccines ineffective. Given that every patient has a different exposure risk to COVID-19 as well as unique risk factors for infection from their individual health history it may be that a steroid injection is appropriate within the optimal waiting period. The decision of when to have an injection is a decision that ultimately should be made between a patient and their physician.
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